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Rapid Response Team and Families

Posted

Specializes in Critical Care. Has 34 years experience.

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Dinith88

Specializes in CCU/CVU/ICU. Has 15 years experience.

Hoping that there will be no RRT calls so that one will not be called away is a fool's utopia..

What???

A 'fools utopia' is one where the RRT doesnt have patients.:yeah:

In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

However, in reality, 99.9% of hospitals dont have dedicated patient-free RRT's.

And...any hospital that lets family members call RRT's, DOES NOT trust the floor nurses' judgment. Period.

A critical-care nurse (or two)...a RT (or two)..and perhaps a doctor...who dont take patients and only respond to codes and RRT's??...THATS your fools utopia for the VAST majority of nurses/hospitals in the nation...(but i agree it would be nice. Just not reality.)

And if you think famlies are better at assessing patients than nurses...well, umm...the floor nurses at the very awesome level-1-trauma-best-in-the-nation hospital must suck. Or adminitration thinks so.

XB9S

Specializes in Advanced Practice, surgery. Has 22 years experience.

There is some great information within this thread could I remind all members to please debate the topic and refrain from personal comments as it only serves to derail the thread.

Thanks

Sharrie

interleukin

Specializes in Mixed Level-1 ICU. Has 14 years experience.

"In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

I sense a bit of sarcasm in your reply.

While it may be "lucky" to have extra staff, the fundamentals are the same regardless of where one practices, how big or small the institution, whatever level.

If nurses are pulled away from their patients, for whatever reason, it opens the door for increased morbidity and mortality for those patients left behind.

You may argue that nurses are assigned to codes and they are pulled away when one is called. But code calls are far fewer that RRT calls and the nurse may be at the RRT call for a very long period of time only to be followed by another call. Sure it happens in codes, but we're talking odds here, not exceptions.

Take nurses away from their patients and it's another place that talks the talk, but doesn't walk the walk.

"However, in reality, 99.9% of hospitals dont have dedicated patient-free RRT's."

Perhaps those places need to reevaluate their budgets in light of the research.

Dinith88

Specializes in CCU/CVU/ICU. Has 15 years experience.

"In the very lucky, very big, awesome level-1 trauma there may be resources allocated for staff (including doctors?) to be a designated RRT and not have patients.

I sense a bit of sarcasm in your reply.

.

Just a bit?

I agree with you. It would be nice to have dedicated RRT with no patients. NOw...if you can lobby for this and convince hospital administrators across the nation...

A pipe dream i'm afraid...

for most of us at least.

Dinith88

Specializes in CCU/CVU/ICU. Has 15 years experience.

Well my team had a family initiated call today. The patient was diophoretic, cp, sob...etc..etc, well the flor nurse told the pt. and family it was anxiety, so the pts. family called are rrt, being the supervisor I went down and checked it out first, well let me tell you it was not anxiety, this patient was having a true emergency, when I got there she was like exausted and almost half dead, well she had a hip replacement 2 days before, and Im glad the family called us she had a massive PE, she was transferred to my SICU immediately, we couldnt get the emboli with the cath lab it was to big, we ended up taking her down to OR for a ride sided thoracotomy, she also ended up with a pneumo. from the CVC. Im just glad we got there and I hope she pulls through.

If this is a common occurence at your hospital then yes families probably need to call RRT's. Or better yet, stay away from your hospital! :typing

That nurse was retarded. Hopefully the rest of your nurses arent. But it sounds like you (and/or administration) thinks they are...

rgroyer1RNBSN, BSN, RN

Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

Dinith, I dont think shes stupid at all, she should have just paid more attention, thats all, for gods sakes shes new anyway, and I work at a very distinguished level 1 trauma facility in St.louis, Im just one of the SICU and ER house supervisors, I just also happen to be someone in charge of a trauma team and an rrt team. I dont think shes stupid at all and she should have just called one of us house sups for help and guidance thats all.

RNFELICITY

Specializes in Not too many areas I haven't dipped into.

Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

I almost didnt want to respond to this...and i hope you're not serious.

From my understanding, this is what the goal was from the beginning.

I would imagine that a life saved vs 20 erroneous runs is ok. We will see how it plays out. I know that we were taught that the family knows the patient the best and they will notice the subtle changes taht we would never know to look for and that might just be the tip to saving a life.

RNFELICITY

Specializes in Not too many areas I haven't dipped into.

From my understanding, this is what the goal was from the beginning.

I would imagine that a life saved vs 20 erroneous runs is ok. We will see how it plays out. I know that we were taught that the family knows the patient the best and they will notice the subtle changes taht we would never know to look for and that might just be the tip to saving a life.

it wouldn't let me edit so ....

I also wanted to add that I was very fearful when I first heard that families had the right to call an RRT, but it has not turned out as bad as I thought. Most families in our hospital have a good enough relationship with the nurse to be able to have their concerns heard. We have had some that were silly, but we have had some nurse called RRT's that were "worthless" as well but we are always supposed to thank the person for calling ans asking for help or another set of eyes.

Pat_Pat RN

Specializes in ER, Med/Surg. Has 8 years experience.

If you as a family member think that something so bad is happening that you need to dial "911" in the hospital, how about stepping into the hallway and yelling that you need some help?

I have to agree, STUPID.

Morettia2, BSN, RN

Specializes in CTICU, Interventional Cardiology, CCU.

At my hosp. if you call a RRT during the day, you have alot of support, all kinds of MD's, Nurses and Resp. people show up. But my exp. working night shift, if you call a RRT at 3am the only people who show up are a resp. therapist, nursing supervisor, the House MD if you are lucky, and I mean very lucky and well that's about it. I have had more than my fair share of frustrating RRT's working night shift.

I had one pt. who was status epilepticus, and began siezing at 4am. I called a RRT nd only a resp. therapist showed up. I was so mad that I called a code blue just to get the MD there to eval. the pt.

I have pt. s/p STROKE, end up stroking out a second time and know tht if I call a RRT I will have no help. So I call the MD's directly. They come and eval.

But RRT teams are great at my hosp. during the day, once night falls, forget about it.

Chayo1989

Specializes in Combined ICU (CCU/Neuro/SICU/MICU. Has 3 years experience.

Guess I could go either way on this one, since IM on the code team and the RRT and Im a house supervisor, guess what you get the same members when you call either, and Im just waiting for an idiot call, thats what everyone on my RRT team calls it when we get some stupid jerk calling us to give his mother a bedpan, or roll her, or betteryet get him something to drink, but its good for the patients that need it we actually try to get them stabilized before they crash, its funny to my teams also the trauma team lol! So if you call us for something stupid the RRT physician just might be a trauma surgeon and he might just rip you a new one.

This is obviously an issue with very strong opinions, you either agree with it or not. As nurses, we are supposed to have the patient's best interest in mind. Instead of saying that having family members activate the RRT is dumb and stupid, shouldn't the cause of why they are asking for those things be explored more (ie, bedpan)? Maybe that floor is so short staffed, and that patient isn't getting those simple things taken care of. As silly a request as that may sound, if we were in those patients shoes, wouldn't that matter?

My facility uses RRT as well; and not all the calls are warranted, but we shouldn't make those floor nurses or family members feel like they shouldn't have called us. Its been my experience that a lot of ICU nurses think that they're better than other nurses. We all have our strengths and weaknesses. Instead of bashing this idea, we need to find ways to make it better.

How is answering an RRT call that's "not worthy of our time" a waste of our time? Is that call keeping you away from sipping your coffee or gossiping? At least, that's been my experience. Fellow staff, (the more experienced staff), get annoyed when asked for help because they are too busy reading the paper, magazine, drinking their coffee or gossiping. Bottom line, patients come first; and whether we like it or not, family members do know the patient a lot better than the nurse at times.

joeyzstj, LPN

Specializes in CVICU, ICU, RRT, CVPACU.

Are you serious? Your hospital is allowing FAMILIES to call RRT? That's (for lack of a better term) stupid. S.T.U.P.I.D.

I almost didnt want to respond to this...and i hope you're not serious.

My facility allows it as well. If a family feels that a floor nurse isnt giving them the attention they need in a change of pt status situation, they can pick up the phone and call the operator who will immediately page us. I think it works well for the most part.

RN1982

Specializes in ICU/Critical Care.

Apparently there is some research regarding RRT and families calling. Something like, the patient has a more likelihood of survival if it's a real emergency. There were gonna start implementing families being allowed to call RRT but I haven't heard anything yet.

canoehead, BSN, RN

Specializes in ER. Has 30 years experience.

Ya know, RRT's clearly have been decreasing codes where they have been implemented BUT...I wonder if increasing the RN to patient ratio wouldn't do the exact same thing.

Of course then you wouldn't have the dramatic saves for the hospital to boast about, and I bet that the hospital gets more money from high acuity patients brought back from the brink....Just some thoughts.

Dinith88

Specializes in CCU/CVU/ICU. Has 15 years experience.

My facility allows it as well. If a family feels that a floor nurse isnt giving them the attention they need in a change of pt status situation, they can pick up the phone and call the operator who will immediately page us. I think it works well for the most part.

I still think it's a dumb idea...and a wee slap in the face of the floor nurses. The message is clear: "...you may not be as good as assessing a patient/situation as the family is..." :argue: Whatever. It's an abuse of the RRT system (and critical-care nurses) i think.

I understand the arguments some nurses may think/give regarding family-guided code-calling and such. But... i think a much better system would be a family 'panic button team' that consists of the nurse manager/charge-nurse and perhaps another nurse from the patient's unit. If these three nurses determine that an actual RRT call is needed...then by all means...please do it. BUT...should this 'family panic response team' determine that grandma's just being neglected and/or has to poop and/or is puking...and/or etc... then the (usually busy) critical-care nurses/docs/resp. techs need not be bothered. Let the floors sevelope and train 'family panic teams' (FPT's i suppose) if they're in favor of them.

But..again...whatever.

Grumpy's Girl

Specializes in Critical Care. Has 34 years experience.

That's a thought, the operator paging the Service Director (manager) - on Days (might interrupt some meetings) with her Charge Nurse her back up, and Supervisor on PM shifts. There is not a Nursing Supervisor on 7-3. We still haven't put the family call in place. I'm glad so far, though I'm very family supportive, I keep going back and forth about this. I'd love to be able to drop and investigate any call. The concern is mainly because the ICU Charge Nurse/RRT Nurse now has a full pt load. (budget) Granted it should be the lightest load, but that sets you up for transfers out and crash ins. Not to mention, are the other staff able to handle your load too while you're gone for at least an hour at a time. We aren't getting very many calls lately but we can't even attend all the RRT calls now, then add Family calls. As it is we've had to add the ED staff to our RRT staff if we can't go. On days there isn't a nursing supervisor so we have to attend the RRT calls.

So, do any of you have a Family Call system P&P to share?

One pro-thought for family calls: during night shift, a family member runs to the nurse's sta with an emegency situation and all the nurses are in pt rooms the family member would have a back up plan by calling the operrator with the family emergency code.

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